S Merve Altıngöz1, Şivge Kurgan2, Canan Önder2, Muhittin A Serdar3, Uğur Ünlütürk4, Metin Uyanık5, Nilgün Başkal4, Dimitris N Tatakis6, Meral Günhan2. 1. Department of Periodontology, Faculty of Dentistry, Lokman Hekim University, Ankara, Turkey. 2. Department of Periodontoloy, Faculty of Dentistry, Ankara University, Ankara, Turkey. 3. Department of Medical Biochemistry, School of Medicine, Acıbadem University, Ankara, Turkey. 4. Department of Endocrinology, Faculty of Medicine, Ankara University, Ankara, Turkey. 5. Department of Medical Biochemistry, School of Medicine, Namık Kemal University, Tekirdağ, Turkey. 6. Division of Periodontology, College of Dentistry, The Ohio State University, Columbus, OH, USA.
Abstract
BACKGROUND: Non-invasive methods for periodontitis diagnosis would be a clinically important tool. This cross-sectional study aimed to investigate the association between oxidative stress, glycation, and inflammation markers and periodontal clinical parameters in periodontitis and periodontally healthy patients with type 2 diabetes and corresponding systemically healthy controls. MATERIAL AND METHODS: Sixty-seven periodontally healthy (DM-H, n = 32) and periodontitis (DM-P, n = 35) patients with type 2 diabetes, and 54 systemically healthy periodontitis (H-P, n = 26) and periodontally healthy (H-H, n = 28) controls were included. Clinical periodontal parameters, body mass index, fasting glucose, hemoglobin A1c (HbA1c), along with saliva and serum 8-hydroxy-2'-deoxyguanosine (8-OHdG), malondialdehyde (MDA), 4-hydroxy-2-nonenal (4-HNE), advanced glycation end products (AGE), AGE receptor (RAGE) and high sensitivity C-reactive protein (hsCRP) levels were recorded and analyzed. RESULTS: Salivary 8-OHdG levels were significantly higher in periodontitis compared to periodontally healthy patients, regardless of systemic status (p<0.001). Salivary MDA levels were significantly higher in all disease groups compared to H-H group (p≤0.004). Serum AGE levels were significantly higher in diabetic groups than systemically healthy groups (p<0.001) and in H-P compared to H-H (p<0.001). Bleeding on probing (BOP) and clinical attachment level (CAL) strongly correlated with salivary 8-OHdG and serum hsCRP (p<0.001). In systemically healthy patients, salivary 8-OHdG was the most accurate marker to differentiate periodontitis from controls (AUC = 0.84). In diabetics salivary 4-HNE and RAGE were the most accurate (AUC = 0.85 for both). CONCLUSION: Salivary 8-OHdG alone or in combination with 4-HNE, AGE and RAGE for diabetics, and salivary 8-OHdG alone or in combination with MDA and hsCRP for systemically healthy persons, could potentially serve as non-invasive screening marker(s) of periodontitis. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.
BACKGROUND: Non-invasive methods for periodontitis diagnosis would be a clinically important tool. This cross-sectional study aimed to investigate the association between oxidative stress, glycation, and inflammation markers and periodontal clinical parameters in periodontitis and periodontally healthy patients with type 2 diabetes and corresponding systemically healthy controls. MATERIAL AND METHODS: Sixty-seven periodontally healthy (DM-H, n = 32) and periodontitis (DM-P, n = 35) patients with type 2 diabetes, and 54 systemically healthy periodontitis (H-P, n = 26) and periodontally healthy (H-H, n = 28) controls were included. Clinical periodontal parameters, body mass index, fasting glucose, hemoglobin A1c (HbA1c), along with saliva and serum 8-hydroxy-2'-deoxyguanosine (8-OHdG), malondialdehyde (MDA), 4-hydroxy-2-nonenal (4-HNE), advanced glycation end products (AGE), AGE receptor (RAGE) and high sensitivity C-reactive protein (hsCRP) levels were recorded and analyzed. RESULTS: Salivary 8-OHdG levels were significantly higher in periodontitis compared to periodontally healthy patients, regardless of systemic status (p<0.001). Salivary MDA levels were significantly higher in all disease groups compared to H-H group (p≤0.004). Serum AGE levels were significantly higher in diabetic groups than systemically healthy groups (p<0.001) and in H-P compared to H-H (p<0.001). Bleeding on probing (BOP) and clinical attachment level (CAL) strongly correlated with salivary 8-OHdG and serum hsCRP (p<0.001). In systemically healthy patients, salivary 8-OHdG was the most accurate marker to differentiate periodontitis from controls (AUC = 0.84). In diabetics salivary 4-HNE and RAGE were the most accurate (AUC = 0.85 for both). CONCLUSION: Salivary 8-OHdG alone or in combination with 4-HNE, AGE and RAGE for diabetics, and salivary 8-OHdG alone or in combination with MDA and hsCRP for systemically healthy persons, could potentially serve as non-invasive screening marker(s) of periodontitis. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.
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Keywords:
4-hydroxy-2-nonenal; 8-Hydroxy-2′-Deoxyguanosine; Diabetes mellitus; Oxidative Stress; Periodontitis; Type 2